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Three-Port Versus Four-Port Laparoscopic Cholecystectomy: Meta-Analysis of Randomized Clinical Trials

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Since the first laparoscopic cholecystectomy was reported, the four-trocar laparoscope has become the golden standard procedure. Some surgeons, however, thought that the three-port technique may be safe, effective, and economic. Our meta-analysis compared the three-port technique to the four-port technique.


We searched the Cochrane Library, MEDLINE, EMBASE, and Chinese Biomedical Literature Database. Quality assessment and data extraction were done by two reviewers independently. The statistical analysis was performed by RevMan4.2.10 software.


A total of five publications comprising 591 patients met the inclusion criteria. The result showed that three-port technique could not reduce the analgesia requirements: the sample mean difference (SMD) and 95% confidence interval (CI) were –0.28 (–0.66, 0.10). There were no significant differences between the two groups in terms of operating time [weighted mean difference (WMD) = 2.08, 95% CI (–3.63, 7.79)], success rate [odds ratio (OR) = 0.99,95% CI (0.31, 3.12)], or postoperative hospital stay [OR = –0.52,95% CI (–1.22, 0.17)].


The current evidence showed that the two groups had similar operating times, success rates, analgesia requirements, and postoperative hospital stays. The methodological qualities of studies are not high, so more high-quality studies are needed for further analysis.

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We thank the co-authors and all of the other authors, who have contributed significantly.

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Correspondence to Kehu Yang.

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Sun, S., Yang, K., Gao, M. et al. Three-Port Versus Four-Port Laparoscopic Cholecystectomy: Meta-Analysis of Randomized Clinical Trials. World J Surg 33, 1904–1908 (2009).

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